Tag Archives: WIPP Chief Advocate

In the final scene of the Wizard of Oz, the dog Toto pulls back the curtain and Dorothy discovers the man behind the curtain is not the great and powerful Wizard, he’s just a little old man with a megaphone. Sometimes, actions in Washington use the megaphone but there is relatively little “behind the curtain.” That’s how the new rule on Association Health Plans (AHPs), issued by the Department of Labor, feels.

It was with great fanfare that the Administration issued new rules for AHPs. WIPP has supported AHPs since its inception as a necessary tool to allow small businesses to band together to create larger health insurance pools, thus creating more competition and better prices in the small business marketplace. Insurance rules adopted during the Affordable Care Act (aka Obamacare) largely prohibited AHPs from a viable option. Because every insurance plan had to cover 10 “essential health benefits” under the ACA, these plans became mute.

When the Department of Labor announced loosening the regulations to allow AHPs, we applauded. WIPP submitted comments urging better pooling mechanisms, a wider range of health plan options and protections for those with pre-existing conditions. We also urged the Department to include a different “commonality of interest” definition, allowing small businesses to band together beyond a trade, industry, or profession. This would have allowed small business organizations to offer AHP membership to its members, including WIPP.

On June 21, the man behind the curtain showed up. The Department of Labor issued its new AHP rules. By deciding to keep the definition of who can join an AHP to a trade, industry, or profession, business organizations like WIPP, cannot offer an AHP. For example, an accountant in Nevada could join an AHP housed in a national association of accountants, but an organization of women business owners, does not qualify as a trade, industry, or profession, according to the new rules. The AHP can have out-of-state members but must comply with the rules of the state in which it is housed, restricting its ability to be a true “across state lines” option. Important to note is that AHPs are not required to offer the 10 essential benefits, which means education for employers and employees who join AHPs is needed.

News reports suggested that small business associations who have supported AHPs in their policy platforms are not going to take advantage of the new rules. That’s because they can’t—their commonality is business owners, not limited to a specific trade, industry or profession. Giving small business owners more health insurance options continues to be part of our policy platform. As premiums continue to rise, small business exchanges set up by the ACA should not be the only option. The Department of Labor could have done so much more than use their megaphone.

Some days I feel talked to death. The 24-hour news cycle, Twitter, Congressional hearings, roundtables, forums – you name it – everyone’s talking. But to quote an Elvis Presley song, “a little less conversation, a little more action, please.”

Congressional inaction didn’t start yesterday. The budget process has been broken for some time. In fact, Congress passed all 12 appropriations bills by the October 1st deadline (the beginning of the fiscal year) just four times in the last 40 years. However, from 2011 to 2016, not a single appropriations bill passed by itself. For the last 7 out of 10 years, Congress has failed to pass a budget. Finally, the last time the Congress passed all 12 of its appropriations bills was 1994.

The same goes for legislation. Historically, this session of Congress is on pace to pass the least amount of legislation in the last 50 years. Congress has passed 194 pieces of legislation signed into law during the first 18 months of the 115th session of Congress. Of those 194, 23 bills were symbolic or ceremonial. Roughly 1.7% of bills introduced this session of Congress have become law, compared to 4.5% of bills in the 105th session (under President Clinton), and 3.3% of bills in the 110th session (under President George W. Bush.)

No one knows better than Congressional Members that the system is broken – especially its fundamental budget responsibility. A little-known effort is commencing on Capitol Hill – the Joint Select Committee on Budget and Appropriations Process Reform. This Committee, comprised of House and Senate Members of both parties, is tasked with recommendations to reset the way Congress budgets and appropriates the taxpayers’ money. Recently, the Committee asked Members of Congress to share recommendations and Speaker Paul Ryan testified that the Congress should do a biennial budget. Others suggested getting rid of the Budget Committee, indexing spending to a percentage of the gross national product and eliminating the debt ceiling vote by making it automatic. What struck me most listening to the hearing was the bipartisan interest in fixing the budget process.

Two former Senate Leaders, Tom Daschle (D) and Trent Lott (R), currently lead the Commission on Political Reform as part of their work at the Bipartisan Policy Center. They have shared three recommendations to address the gridlock:

Move to a two-year budget cycle, allowing more time for Members to understand programs under their jurisdiction in-depth;

Get rid of the Senate filibuster but make the majority 60 votes, not 51 votes;

Have a minimum number of amendments that can be offered to legislation, thus encouraging Members to get involved in legislating.

Being an eternal optimist, I believe the Congress can fix the process. One small ray of hope is the Senate Appropriations Committee, which is moving its bills at a much faster clip than we have seen in many years. I anticipate the Joint Select Committee on Budget Reform will produce serious recommendations.

Changing the rules will lead to action. Members of Congress will get back to legislating and time will be spent considering serious issues that need resolution. Getting back to an action-oriented Congress would be the first step toward more action and less talk.